Benjamin Jared Grossnickle, LCSW-A, LCAS-A is a medicare enrolled "Social Worker - Clinical" provider in Greenville, North Carolina. His current practice location is
2602 Courtier Dr, Greenville, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(252) 752-0483.
Benjamin Jared Grossnickle is licensed to practice in North Carolina (license number C017988) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124860705.
Healthcare Provider's Profile
Full Name | Benjamin Jared Grossnickle |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 2602 Courtier Dr, Greenville, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124860705
- Provider Enumeration Date: 06/12/2024
- Last Update Date: 01/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 3779004601
- Enrollment ID: I20250307003517
Medical Identifiers
Medical identifiers for Benjamin Jared Grossnickle such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124860705 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAS-29816 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | C017988 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Benjamin Jared Grossnickle allows following entities to bill medicare on his behalf.
Entity Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306167713 PECOS PAC ID: 7618161407 Enrollment ID: O20101105000534 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Benjamin Jared Grossnickle is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Benjamin Jared Grossnickle, LCSW-A, LCAS-A 2602 Courtier Dr, Greenville, NC 27834-7818 Ph: (252) 752-0483 | Benjamin Jared Grossnickle, LCSW-A, LCAS-A 2602 Courtier Dr, Greenville, NC 27834-7818 Ph: (252) 752-0483 |
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